Oral and cardiovascular disease associations do not call for extraction of teeth

Abstract 

Objective This paper reviews the existing evidence examining the relationship between periodontal disease, tooth loss, and cardiovascular disease to determine whether tooth extractions reduce the risk of CVD. Study Design All published cohort studies that evaluated both periodontal disease and tooth loss in relation to the risk of coronary heart disease (CHD) or stroke were included in this review. Results Tooth loss appears to be associated with a similar or greater risk for CHD and stroke than does periodontal disease, in all but 1 out of 8 comparisons. The association between periodontal disease and CHD ranges from a relative risk of 1.01 in 1 study to 1.37 in another study after controlling for common risk factors (ie, a 1% to 37% increased risk of CHD among people with periodontal disease compared with those without), whereas the relative risk for tooth loss and CHD ranges from 1.01 to 1.90 across studies (a 1% to 90% increase). The association between periodontal disease and stroke ranges from a relative risk of 1.01 to 2.11, whereas the relative risk for tooth loss and stroke ranges from 1.07 to 1.63 across studies. The associations are modest and similar for both periodontal disease and tooth loss. Conclusion The scientific evidence to date that relates both periodontal disease and tooth loss to CHD and stroke does not support the removal of teeth that have periodontal disease as a means for reducing CVD risk because tooth loss shows a similar association with CVD.

J Evid Base Dent Pract 2002;2:261-6